Teledermatology initiative - British Columbia Medical Association

Consult Derm has been used by over 500 Family
Physicians in Alberta and the Northwest Territories over
the last two years. 1
Program Impacts and User
Satisfaction
With a turnaround time from store and forward
teledermatology referral to consult of about a week, the
Teledermatology project on Salt Spring Island has
completed 115 teledermatology referrals as of July 1,
2012. 2
According to a patient satisfaction research paper by Dr.
Jacqueline Cooper, the Teledermatology project has
been well-received by patients. Findings related to
satisfaction levels among the 33 patients who
participated in the Teledermatology pilot project revealed
that:
Ninety-five percent of patients strongly agreed or
agreed that store and forward teledermatology was
more convenient than the traditional referral system
of going off island to a dermatology clinic.
All patients (100%) were comfortable with pictures
being taken and medical history uploaded through
the secure web site.
Seventy-three percent of patients were confident
that the Dermatologist could make an accurate
diagnosis using the store and forward
teledermatology system. The remaining patients
were ‘neutral’.
Eighty-six percent of patients were satisfied with the
teledermatology consult. Only one patient was
unsatisfied due to time delay.
Eighty-six percent of patients prefer store and
forward teledermatology to the traditional referral
system.
Program Efficiency and Economy
A Canadian Agency for Drugs and Technologies in
Health Report summarizes the findings of economic
evaluations of teledermatology. 3 According to the report,
the average total cost per patient is comparatively lower
with store and forward teledermatology versus
conventional dermatological care, especially when costs
associated with lost productivity are considered.
Traditional face-to-face dermatological consultation or
real-time dermatology using teleconference requires
coordination of patient and physician schedules as well
1 Dr. Shane Barclay. Teledermatology for BC: A pilot project sponsored by the
Shared Care Committee of the BCMA and Ministry of Health. PowerPoint
Presentation. February 2012.
2 Dr. Shane Barclay. July 12, 2012.
3 Sarah Ndegwa, Wendy Prichett-Pejic and Sarah McGill. Teledermatology
Services: Rapid Review of Diagnostic, Clinical Management, and Economic
Outcomes. Canadian Agency for Drugs and Technologies in Health’s 2010
Report. October 2010.
http://cadth.ca/media/pdf/H0502_Teledermatology_Report_e.pdf.
as overhead and resources. According to the Canadian
Agency for Drugs and Technologies in Health Report,
the application of teledermatology technology, on the
other hand, can provide a more efficient and economical
solution to care. 4
From a Family Physician’s perspective, the only costs
are the digital cameras, which range from $150 to $300.
The initial FP office visit with picture taking, referral and
follow-up would be billed as a usual "0100" type service.
Effectiveness
Research indicates that this service can be effective and
reliable, save time, save cost and can be accepted and
appreciated by patients and referring physicians. 5
Dermatology studies show that: 6
The diagnosis and treatment plan made using the
system is as effective as in person processes.
Most patients (more than 80%) prefer
teledermatology to live dermatology visits.
This form of teledermatology is cost-effective to the
system in terms of both travel and incidental costs,
as well as loss of work income for patients having to
travel long distances to see a Dermatologist.
In Alberta, Consult Derm has reduced the average
wait time to see a Dermatologist from 104 days to
less than 3 days.
Over 500 referring Family Physicians currently use
the system in Alberta and the Northwest Territories,
accounting for more than 1,500 consults per year.
Consult Derm Screen Shots
4 Louise Gagnon. Remote Viewing: Teledermatology Increases Access to
Specialists in Canada. Dermatology Times. April 1, 2008.
5 David Moreno-Ramirez, Lara Ferrandiz; Adoracion Nieto-Garcia, Rafael
Carrasco, Pedro Moreno-Alvarez, Rafael Galdeano, Esther Bidegain, Juan J.
Rios-Martin and Francisco M. Camacho. Store-and-Forward Teledermatology in
Skin Cancer Triage Experience and Evaluation of 2009 Teleconsultations. 2007.
479-483.
6 Dr. Shane Barclay. Teledermatology for BC: A pilot project sponsored by the
Shared Care Committee of the BCMA and Ministry of Health. PowerPoint
Presentation. February 2012.